Treatment of aspirin exacerbated respiratory disease with a low salicylate diet: a pilot crossover study

Otolaryngol Head Neck Surg. 2015 Jan;152(1):42-7. doi: 10.1177/0194599814555836. Epub 2014 Oct 24.


Objective: Aspirin exacerbated respiratory disease (AERD) is comprised of aspirin/acetylsalicylic acid (ASA) sensitivity, bronchial asthma, and nasal polyposis. Treatment of this condition is challenging and may include topical/systemic steroids, endoscopic sinus surgery, and/or aspirin desensitization.

Study design: A prospective crossover pilot study (n = 10) was conducted in which patients were randomized into either of 2 groups with 6 weeks of regular diet (R) or 6 weeks of a low salicylate diet (LS).

Setting: The study was conducted in a tertiary otolaryngology clinic.

Subjects: Patients with AERD were enrolled in the study.

Methods: Subjective (Sino-nasal Outcome Test-22 [SNOT-22], Nasal Sinus Symptom Scale [NSSS], and the Asthma Control Questionnaire-7 [ACQ-7]) and objective outcome instruments (Peri-Operative Sinus Evaluation [POSE] and Lund-Kennedy Endoscopic Score [LKES]) were used to evaluate patients at baseline, 6 weeks (at crossover), and 12 weeks.

Results: Wilcoxon rank sum tests demonstrated that patients on the low salicylate diet had improved scores compared to their regular diet when evaluated by 4 of the 5 outcome measures (SNOT-22 pLS = 0.0059, NSSS pLS = 0.0195, LKES pLS = 0.0039, POSE pLS = 0.005).

Conclusion: Results of the pilot study indicate that implementation of a low salicylate diet improves the nasal symptoms and nasal endoscopy findings of individuals with AERD. Further research is required to support these findings.

Keywords: aspirin exacerbated respiratory disease; asthma; low salicylate diet; nasal polyps; salicylates; sinusitis.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aspirin / adverse effects*
  • Asthma / chemically induced
  • Asthma / complications
  • Cross-Over Studies
  • Desensitization, Immunologic
  • Drug Hypersensitivity / diet therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nasal Polyps / chemically induced
  • Nasal Polyps / complications
  • Pilot Projects
  • Prospective Studies
  • Respiratory Tract Diseases / chemically induced*
  • Respiratory Tract Diseases / diet therapy*
  • Rhinitis / chemically induced
  • Rhinitis / complications
  • Salicylates / administration & dosage*
  • Single-Blind Method
  • Sinusitis / chemically induced
  • Sinusitis / complications


  • Salicylates
  • Aspirin